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首页> 外文期刊>Journal of Brachial Plexus and Peripheral Nerve Injury >Acute nerve compression and the compound muscle action potential
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Acute nerve compression and the compound muscle action potential

机译：急性神经压迫和复合肌肉动作电位

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Detecting acute nerve compression using neurophysiologic studies is an important part of the practice of clinical intra-operative neurophysiology. The goal of this paper was to study the changes in the compound muscle action potential (CMAP) during acute mechanical compression. This is the type of injury most likely to occur during surgery. Thus, understanding the changes in the CMAP during this type of injury will be useful in the detection and prevention using intra-operative neurophysiologic monitoring.The model involved compression of the hamster sciatic nerve over a region of 1.3 mm with pressures up to 2000 mmHg for times on the order of 3 minutes. In this model CMAP amplitude dropped to 50% of its baseline value when a pressure of roughly 1000 mmHg is applied while, at the same time, nerve conduction velocities decline by only 5%. The ability to detect statistically significant changes in the CMAP at low force levels using other descriptors of the CMAP including duration, latency variation, etc alone or in conjunction with amplitude and velocity measures was investigated. However, these other parameters did not allow for earlier detection of significant changes.This study focused on a model in which nerve injury on a short time scale is purely mechanical in origin. It demonstrated that a pure compression injury produced large changes in CMAP amplitude prior to large changes in conduction velocity. On the other hand, ischemic and stretch injuries are associated with larger changes in conduction velocity for a given value of CMAP amplitude reduction.
机译：使用神经生理学研究检测急性神经压迫是临床术中神经生理学实践的重要组成部分。本文的目的是研究急性机械压迫期间复合肌肉动作电位（CMAP）的变化。这是最可能在手术期间发生的伤害类型。因此，了解这种损伤过程中CMAP的变化将有助于在术中使用神经生理学监测来进行检测和预防。该模型涉及将仓鼠坐骨神经压在1.3 mm的区域内，压力高达2000 mmHg。时间大约为3分钟。在此模型中，当施加大约1000 mmHg的压力时，CMAP振幅下降至其基线值的50％，而神经传导速度仅下降5％。研究了使用CMAP的其他描述符（包括持续时间，潜伏期变化等）单独或结合幅度和速度测量来检测低力水平下CMAP的统计显着变化的能力。但是，这些其他参数并不能早期检测出明显的变化。这项研究的重点是在短时间范围内神经损伤纯粹是机械性起源的模型。结果表明，在传导速度发生较大变化之前，单纯的压迫性损伤会导致CMAP幅度发生较大变化。另一方面，对于给定的CMAP振幅降低值，缺血和拉伸损伤与传导速度的较大变化相关。

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